Paediatric and adolescent diabetic ketoacidosis

Diabetic ketoacidosis (DKA) is one of the two acute emergency situations in those who have diabetes mellitus. DKA should be identifiable and is often preventable. Any associated complications of DKA should also be preventable with proper education and treatment. Awareness of presenting signs and symptoms, on the part of the general public, primary care providers and emergency department personnel, should help minimise the severity of DKA through earlier diagnosis and focusing on appropriate physiologic treatment as well as close, ongoing monitoring to minimise potential lethal DKA complications such as cerebral oedema. Missed diagnosis, late diagnosis, inappropriate treatment, delayed treatment and lack of appropriate monitoring are usually associated with more morbidity and mortality as well as increased hospital costs. Insulin treatment is only one part of DKA management. Fluid and electrolyte monitoring and treatment are often a critical aspect of such management. All aspects of DKA recognition, treatment and prevention must be emphasised to decrease DKA morbidity and mortality around the world. Copyright (C) 2014 John Wiley & Sons.